[Congressional Record Volume 149, Number 137 (Wednesday, October 1, 2003)]
[Senate]
[Pages S12285-S12289]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DODD (for himself, Mr. Sarbanes, and Mr. Reed):
  S. 1697. A bill to establish the elderly housing plus health support 
demonstration program to modernize public housing for elderly and 
disabled persons; to the Committee on Banking, Housing, and Urban 
Affairs.
  Mr. DODD. Mr. President, I rise today to introduce a bill that will 
help address a growing problem in America--our ability to provide safe 
and affordable housing that meets the needs of older Americans. 
Currently there are 35 million Americans over 65 years old. That number 
will double within the next 30 years. By 2030, 20 percent of the U.S. 
population will be over 65 years old.
  Nearly one third of all public housing units are occupied by senior 
citizens. This figure has been steadily growing in recent years and 
will undoubtedly continue to grow in the future. It is critically 
important that we remain committed to providing low-income seniors with 
safe and affordable housing.
  The bill I am introducing will promote the development of assisted 
living programs to provide a wide range of services, including medical 
assistance, housekeeping services, hygiene and grooming, and meals 
preparation. Providing these services will in turn give older Americans 
greater opportunities to decide for themselves where they live and how 
they exercise their independence.
  The Elderly Housing Plus Supportive Health Support Demonstration Act, 
will provide Federal grants to allow public housing authorities around 
the country to develop new strategies for providing better housing for 
senior citizens. The bill will give public housing authorities the 
tools they need to improve our public housing stock so our seniors will 
not be prematurely forced out of their homes. The bill authorizes 
competitive grants through the Department of Housing and Urban 
Development to upgrade and reconfigure elderly buildings, and buildings 
with elderly and non-elderly disabled residents. The bill will also 
provide funding for service coordinators and/or congregate services 
programs.
  Unfortunately, as we examine the public housing stock across the 
country from the perspective of older Americans, we find a bleak 
situation. Over 66 percent of existing public housing units are more 
than 30 years old and most are not designed to meet the needs of older 
Americans. For example, too few of our housing units are equipped to 
facilitate mobility for those in wheelchairs. Even such simple things 
as having a kitchen counter top that can be reached from a wheelchair 
may make the difference between a senior being able to stay in his or 
her home or having to leave, often to be sent to an institution where 
seniors have less independence and control over their lives.
  Because most public housing seniors are Medicaid-eligible, the bill 
will also open a path to reducing Medicaid costs, 42 percent of which 
goes to housing elders in costly nursing homes. The cost to the 
Medicaid program of a beneficiary living in public housing converted to 
assisted living has been shown to be as much as one-third that paid to 
a nursing home on a long-term per capita basis.

[[Page S12288]]

  The scarceness of affordable assisted living units has other social 
costs that we must consider as we set national housing policies for the 
future. Often, the cost of taking care of an aging family member can be 
devastating to American families. Too often, working men and women are 
torn between the need to maintain their jobs and the desire to provide 
the best possible care to their aging family members.
  Advances in medicine are allowing us to live longer, healthier lives. 
Longevity is a great blessing, but it also poses significant challenges 
for individuals, families, and society as whole. One of the greatest 
challenges we will face in the decades ahead is the challenge of 
developing new kinds of housing that respond to the needs of our 
growing elderly population.
  It is my hope that this bill will generate earnest discussion on 
these important matters and will ultimately lead to action to ensure 
that every American senior can live in security and dignity.
  I ask unanimous consent that the text of the Elderly Housing Plus 
Health Support Demonstration Act be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1697

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Elderly Housing Plus Health 
     Support Demonstration Act''.

     SEC. 2. FINDINGS AND PURPOSES.

       (a) Findings.--Congress finds that--
       (1) there are at least 34,100,000 Americans who are 65 
     years of age and older, and persons who are 85 years of age 
     or older comprise almost one-quarter of that population;
       (2) the Bureau of the Census of the Department of Commerce 
     estimates that, by 2030, the elderly population will double 
     to 70,000,000 persons;
       (3) according to the Department of Housing and Urban 
     Development report ``Housing Our Elders--A Report Card on the 
     Housing Conditions and Needs of Older Americans'', the 
     largest and fastest growing segments of the older population 
     include many people who have historically been vulnerable 
     economically and in the housing market--women, minorities, 
     and people over the age of 85;
       (4) many elderly persons are at significant risk with 
     respect to the availability, stability, and accessibility of 
     affordable housing;
       (5) one-third of public housing residents are approximately 
     62 years of age or older, making public housing the largest 
     Federal housing program for senior citizens;
       (6) the elderly population residing in public housing is 
     older, poorer, frailer, and more racially diverse than the 
     elderly population residing in other assisted housing;
       (7) two-thirds of the public housing developments for the 
     elderly, including those that also serve the disabled, were 
     constructed before 1970 and are in dire need of major 
     rehabilitation and configuration, such as rehabilitation to 
     provide new roofs, energy-efficient heating, cooling, utility 
     systems, accessible units, and up-to-date safety features;
       (8) many of the dwelling units in public housing 
     developments for elderly and disabled persons are undersized, 
     are inaccessible to residents with physical limitations, do 
     not comply with the requirements under the Americans with 
     Disabilities Act of 1990, or lack railings, grab bars, 
     emergency call buttons, and wheelchair accessible ramps;
       (9) a study conducted for the Department of Housing and 
     Urban Development found that the cost of the basic 
     modernization needs for public housing for elderly and 
     disabled persons exceeds $5,700,000,000;
       (10) a growing number of elderly and disabled persons face 
     unnecessary institutionalization because of the absence of 
     appropriate supportive services and assisted living 
     facilities in their residences;
       (11) for many elderly and disabled persons, independent 
     living in a non-institutionalization setting is a preferable 
     housing alternative to costly institutionalization, and would 
     allow public monies to be more effectively used to provide 
     necessary services for such persons;
       (12) congregate housing and supportive services coordinated 
     by service coordinators is a proven and cost-effective means 
     of enabling elderly and disabled persons to remain in place 
     with dignity and independence;
       (13) the effective provision of congregate services and 
     assisted living in public housing developments requires the 
     redesign of units and buildings to accommodate independent 
     living;
       (14) most of the elderly who reside in public housing are 
     eligible for Medicaid to pay for the cost of their being 
     institutionalized in nursing homes;
       (15) nursing home costs now exceed 42 percent of the entire 
     Medicaid program; and
       (16) by providing a nursing home resident the choice of 
     assisted living in public housing instead, the Federal 
     Government can save as much as three-quarters of the long 
     term per capita Medicaid costs and at the same time allow a 
     frail senior to age in place.
       (b) Purposes.--The purposes of this Act are--
       (1) to establish a demonstration program to make 
     competitive grants to provide state-of-the-art, health-
     supportive housing with assisted living opportunities for 
     elderly and disabled persons;
       (2) to provide funding to enhance, make safe and 
     accessible, and extend the useful life of public housing 
     developments for the elderly and disabled and to increase 
     their accessibility to supportive services;
       (3) to provide elderly and disabled public housing 
     residents a readily available choice in living arrangements 
     by utilizing the services of service coordinators and 
     providing a continuum of care that allows such residents to 
     age in place;
       (4) to incorporate congregate housing service programs more 
     fully into public housing operations; and
       (5) to accomplish such purposes and provide such funding 
     under existing provisions of law that currently authorize all 
     activities to be conducted under the program.

     SEC. 3. DEFINITIONS.

       In this Act:
       (1) Assisted living facility.--The term ``assisted living 
     facility'' means any public housing project for the elderly, 
     or for the elderly and the non-elderly disabled, that is 
     operated in accordance with applicable laws and provides to 
     the residents any combination of the following services:
       (A) Meal service adequate to meet nutritional need.
       (B) Housekeeping aid.
       (C) Personal assistance.
       (D) Transportation services.
       (E) Health-related services.
       (F) Such other services as are considered important for 
     maintaining independent living.
       (2) Elderly and disabled families.--The term ``elderly and 
     disabled families'' means families in which 1 or more persons 
     is an elderly person or a person with disabilities.
       (3) Elderly person.--The term ``elderly person'' means a 
     person who is 62 years of age or older.
       (4) Person with disabilities.--The term ``person with 
     disabilities'' has the same meaning as in section 3(b)(3)(E) 
     of the United States Housing Act of 1937 (42 U.S.C. 
     1437a(b)(3)(E)).
       (5) Public housing agency.--The term ``public housing 
     agency'' has the same meaning as in section 3(b)(6)(A) of the 
     United States Housing Act of 1937 (42 U.S.C. 
     1437a(b)(6)(A)).
       (6) Secretary.--The term ``Secretary'' means the Secretary 
     of Housing and Urban Development.

     SEC. 4. AUTHORITY FOR ELDERLY HOUSING PLUS HEALTH SUPPORT 
                   PROGRAM.

       The Secretary shall establish an elderly housing plus 
     health support demonstration program (referred to in this Act 
     as the ``demonstration program'') in accordance with this Act 
     to provide coordinated funding to public housing projects for 
     elderly and disabled families selected for participation 
     under section 5, to be used for--
       (1) rehabilitation or re-configuration of such projects or 
     the acquisition and rehabilitation of an existing assisted 
     living facility in cases where the public housing agency has 
     no elderly housing stock suitable for conversion;
       (2) the provision of space in such projects for supportive 
     services and community and health facilities;
       (3) the provision of service coordinators for such 
     projects; and
       (4) the provision of congregate services programs in or 
     near such projects.

     SEC. 5. PARTICIPATION IN PROGRAM.

       (a) Application and Plan.--To be eligible to be selected 
     for participation in the demonstration program, a public 
     housing agency shall submit to the Secretary--
       (1) an application, in such form and manner as the 
     Secretary shall require; and
       (2) a plan for the agency that--
       (A) identifies the public housing projects for which 
     amounts provided under this Act will be used, limited to 
     projects that are designated or otherwise used for 
     occupancy--
       (i) only by elderly families; or
       (ii) by both elderly families and disabled families; and
       (B) provides for local agencies or organizations to 
     establish or expand the provision of health-related services 
     or other services that will enhance living conditions for 
     residents of public housing projects of the agency, primarily 
     in the project or projects to be assisted under the plan.
       (b) Selection and Criteria.--
       (1) Selection.--The Secretary shall select public housing 
     agencies for participation in the demonstration program based 
     upon a competition among public housing agencies that submit 
     applications for participation.
       (2) Criteria.--The competition referred to in paragraph (1) 
     shall be based upon--
       (A) the extent of the need for rehabilitation or re-
     configuration of the public housing projects of an agency 
     that are identified in the plan of the agency pursuant to 
     subsection (a)(2)(A);
       (B) the past performance of an agency in serving the needs 
     of elderly public housing residents or non-elderly, disabled 
     public housing residents given the opportunities in the 
     locality;

[[Page S12289]]

       (C) the past success of an agency in obtaining non-public 
     housing resources to assist such residents given the 
     opportunities in the locality; and
       (D) the effectiveness of the plan of an agency in creating 
     or expanding services described in subsection (a)(2)(B).

     SEC. 6. CONFIGURATION AND CAPITAL IMPROVEMENTS.

       (a) Grants.--
       (1) In general.--The Secretary shall make grants to public 
     housing agencies selected for participation under section 5, 
     to be used only--
       (A) for capital improvements to rehabilitate or configure 
     public housing projects identified in the plan submitted 
     under section 5(a)(2)(A);
       (B) to provide space for supportive services and for 
     community and health-related facilities primarily for the 
     residents of projects identified in the plan submitted under 
     section 5(a)(2)(A); and
       (C) for the cost of acquisition by a public housing agency 
     of an existing assisted living facility that is in need of 
     rehabilitation in cases where the public housing agency has 
     no elderly housing stock suitable for conversion.
       (2) Source of funds.--Grants shall be made under this 
     section from funds made available for the demonstration 
     program in accordance with subsection (c).
       (3) Inapplicability of other provisions.--Section 9(c)(1) 
     of the United States Housing Act of 1937 (42 U.S.C. 
     1437g(c)(1)) does not apply to grants made under this 
     section.
       (b) Allocation.--Grants funded in accordance with this 
     section shall--
       (1) be allocated among public housing agencies selected for 
     participation under section 5 on the basis of the criteria 
     established under section 5(b)(2); and
       (2) be made in such amounts and subject to such terms as 
     the Secretary shall determine.
       (c) Authorization of Appropriations.--There are authorized 
     to be appropriated for the demonstration program, to make 
     grants in accordance with this section--
       (1) $100,000,000 for fiscal year 2004; and
       (2) such sums as may be necessary for fiscal year 2005 and 
     each subsequent fiscal year.

     SEC. 7. SERVICE COORDINATORS.

       (a) Grants.--
       (1) In general.--The Secretary shall make grants to public 
     housing agencies selected for participation under section 5, 
     to be used only--
       (A) for public housing projects for elderly and disabled 
     families for whom capital assistance is provided under 
     section 6; and
       (B) to provide service coordinators and related activities 
     identified in the plan of the agency pursuant to section 
     5(a)(2), so that the residents of such public housing 
     projects will have improved and more economical access to 
     services that support the health and well-being of the 
     residents.
       (2) Source of funds.--Grants shall be made under this 
     section from funds made available for the demonstration 
     program in accordance with subsection (c).
       (3) Inapplicability of other provisions.--Section 9(c)(1) 
     of the United States Housing Act of 1937 (42 U.S.C. 
     1437g(c)(1)) does not apply to grants made under this 
     section.
       (b) Allocation.--The Secretary shall provide a grant 
     pursuant to this section, in an amount not to exceed 
     $100,000, to each public housing agency that is selected for 
     participation under section 5.
       (c) Authorization of Appropriations.--There are authorized 
     to be appropriated for the demonstration program, to make 
     grants in accordance with this section--
       (1) $2,000,000 for fiscal year 2004; and
       (2) such sums as may be necessary for fiscal year 2005 and 
     each subsequent fiscal year.

     SEC. 8. CONGREGATE HOUSING SERVICES PROGRAMS.

       (a) Grants.--
       (1) In general.--The Secretary shall make grants to public 
     housing agencies selected for participation under section 5, 
     to be used only--
       (A) in connection with public housing projects for elderly 
     and disabled families for which capital assistance is 
     provided under section 6; and
       (B) to carry out a congregate housing service program 
     identified in the plan of the agency pursuant to section 
     5(a)(2) that provides services as described in section 
     202(g)(1) of the Housing Act of 1959 (12 U.S.C. 1701q(g)(1)).
       (2) Source of funds.--Grants shall be made under this 
     section from funds made available for the demonstration 
     program in accordance with subsection (c).
       (3) Inapplicability of other provisions.--Other than as 
     specifically provided in this section--
       (A) section 9(c)(1) of the United States Housing Act of 
     1937 (42 U.S.C. 1437g(c)(1)) does not apply to grants made 
     under this section; and
       (B) section 202 of the Housing Act of 1959 (12 U.S.C. 
     1701q) does not apply to grants made under this section.
       (b) Allocation.--The Secretary shall provide a grant 
     pursuant to this section, in an amount not to exceed 
     $150,000, to each public housing agency that is selected for 
     participation under section 5.
       (c) Authorization of Appropriations.--There are authorized 
     to be appropriated for the demonstration program, to make 
     grants in accordance with this section--
       (1) $3,000,000 for fiscal year 2004; and
       (2) such sums as may be necessary for fiscal year 2005 and 
     each subsequent fiscal year.

     SEC. 9. SAFEGUARDING OTHER APPROPRIATIONS.

       Amounts authorized to be appropriated under this Act to 
     carry out this Act are in addition to any amounts authorized 
     to be appropriated under any other provision of law, or 
     otherwise made available in appropriations Acts, for 
     rehabilitation of public housing projects, for service 
     coordinators for public housing projects, or for congregate 
     housing services programs.
                                 ______